But one bit of unfinished business remained. The trauma surgeon sought damages in state court over his 2007 demotion. That was, he said, an act of retaliation after he had blown the whistle to his department chairman.

On Monday, Gentilello’s bid was dealt a blow when an appeals court ruled that a powerful legal shield enjoyed by state agencies protected UTSW against this case as well.

The 5th District Court of Appeals in Dallas sided with a lower court in arriving at its decision. It did not delve into the substance of Gentilello’s billing fraud allegations. Instead it addressed whether the case could proceed in light of the sovereign immunity doctrine. (The opinion is at end of this post.)

The Texas Supreme Court ruled that Dr. Larry Gentilello's internal warnings about possible billing fraud did not qualify him for whistle-blower protection under state law.

The Texas Supreme Court has dismissed on technical grounds a UT Southwestern Medical Center trauma surgeon’s nearly six-year claim that he was demoted in retaliation for alleging billing fraud and lax resident supervision.

In an opinion issued late last week, Justice Don R. Willett wrote on the court’s behalf that the Texas Whistleblower Act protects employees who report potential wrongdoing to an “appropriate law enforcement authority.”

But Gentilello had warned his supervisor, the chairman of UTSW’s surgery department. The justices concluded the chairman, Dr. Robert Rege, lacked the kind of regulatory or policing power described in the act.

“This is a legislatively-mandated legal classification, one tightly drawn, and we cannot judicially loosen it,” according to the opinion, which I uploaded at this post’s end. “Other states protect purely internal whistle-blowing, but under our Legislature’s narrower view, a whistleblower cannot reasonably believe his supervisor is an appropriate law-enforcement authority if the supervisor’s power extends no further than ensuring the governmental body itself complies with the law.”

The Supreme Court did not rule on the substance of Gentilello’s allegations. The decision overturned those of two lower courts, which had let Gentilello proceed despite legal shields that generally make entities like UTSW immune to such lawsuits.

As we reported this morning , the devastating report by federally installed safety monitors into Parkland’s patient care and operations also faulted UT Southwestern Medical Center in Dallas.

UTSW uses Parkland as its primary teaching hospital, and its faculty physicians practice there and supervise resident doctors-in-training who deliver much of the patient care. Among the concerns cited by monitors: Unsupervised residents botched several invasive procedures, including draining chest fluid from the wrong site.

My colleague, Sue Goetinck Ambrose, tried today to reach the head of the University of Texas System’s health affairs operations, Dr. Kenneth Shine. But he declined, through a spokesman, to comment because he hadn’t read the report. Instead, the spokesman shared this prepared statement with Sue:

“We have not read the report as it has just recently become available. UT Southwestern and President Dan Podolsky are fully committed to operating a top-flight residency training program and comprehensive academic health center. In an organization as large as Parkland, errors will occasionally occur, just as in any other large healthcare system. That said, the overall quality and care provided by the residency training program is very good, and UT Southwestern is committed to continually improving the residency training program.”

A few readers asked why we haven’t reported on a court ruling that favored UT Southwestern Medical Center in a civil rights lawsuit brought by a faculty doctor, given our recent coverage of the school and its main teaching hospital, Parkland Memorial.

For much of the last year, we’ve investigated complaints of unsupervised medical residents, patient harm and improper Medicare and Medicaid billing by UT Southwestern and its hospital partner, Parkland. We focused on those issues because of the impact each has on patients and taxpayers who support the two public institutions.

The court ruling dealt narrowly with the question of whether UT Southwestern officials denied Dr. Larry Gentilello (pictured) due process in stripping him of his chairmanship of the surgery department’s burn, trauma and critical care division in 2007.Continue reading →

Dallas Morning News managing editor George Rodrigue used his Ask The Editor column this week to respond to a letter from a top official with University HealthSystem Consortium highlighting Parkland Memorial Hospital’s recent statistical performance in several selected areas of patient care.

UHC, which is supported financially by Parkland and other hospitals, collects and shares data among its members, who represent more than 90 percent of the nation’s nonprofit academic medical centers. Parkland’s leader, Dr. Ron Anderson, serves on the UHC board.

The official’s letter, as George notes, has become entwined with public-relations efforts at Parkland and UT Southwestern Medical School, which supplies Parkland’s faculty and its resident doctors-in-training.

As part of our ongoing investigation, we’ve sought various statistical information from both taxpayer-funded institutions, as well as UHC, about patient-care outcomes. But all have declined to release it.

I wanted to draw your attention to a documentary video that accompanied Brooks Egerton’s stories Sunday, as part of our ongoing investigation into patient care at taxpayer-funded Parkland Memorial and UT Southwestern Medical Center.

The six-minute video, shot by one of The News’ award-winning photojournalists, Mona Reeder, explores the aftermath of Jessie Mae Ned’s surgery and postoperative care.

Jessie Mae, a former Parkland employee, went in for knee-replacement surgery. She expected her UT Southwestern specialist, Dr. Frank Gottschalk (shown top right), to operate on her; he was the one named on her surgical consent form. But other records show a resident doctor in training, Christopher Espinoza-Ervin (lower right), did instead.

A leg artery was damaged in surgery, leading to Jessie Mae losing her leg. The hospital and UT Southwestern have refused to discuss her case.

You can find the rest of Brooks’ Sunday stories and our investigation’s archives by clicking here.

Sharon L. Riley, who this year helped lead planning for UT Southwestern Medical Center’s new $800 million hospital, is leaving her post at the end of October.

President Daniel Podolsky and executive VP for health affairs Bruce Meyer announced in a recent e-mail that Riley had informed them of her decision “to give priority attention to other dimensions of her life.” They didn’t elaborate, and she wasn’t quoted in the e-mail, which I’ve included at the end of this post.

“We are very grateful to Sharon for what has been accomplished under her leadership,” Podolsky and Meyer said in the email.

The announcement of Riley’s departure came shortly after UT Southwestern won final approval for its new 12-story hospital. No permanent replacement was named.

My colleagues and I reported on faculty meeting notes taken by a surgeon and later included in a 2007 whistleblower lawsuit that alleged lax oversight of residents, as doctors-in-training are known. According to those notes, Valentine said it was “OK for residents to make mistakes” on patients “even if they could have been avoided with better faculty supervision.”

Back in May, a federal jury told UT Southwestern Medical Center to pay more than $3.6 million to a doctor who said he faced racial discrimination and retaliation after resisting pressure to commit billing fraud.

Now a state appeals court has put another doctor employed by the Dallas medical school, Larry Gentilello (right), a big step closer to getting similar allegations in front of jurors.

Gentilello chaired the burn, trauma and critical care division of UT Southwestern’s surgery department until 2007. The school says it demoted him because he didn’t get along with other surgery professors and the trainee doctors — better known as residents — whom they’re supposed to supervise at their main teaching hospital, Parkland.

In a lawsuit, Gentilello says he was stripped of his chairmanship because he complained about lax supervision of the residents, which could endanger patients and lead to billing fraud. (UT Southwestern can’t legally bill Medicare for a surgery performed by residents unless a faculty physician directly supervised it. The school denies wrongdoing.)

UT Southwestern Medical Center and Parkland Memorial Hospital are known for their contributions to medical research and public health. But have those accomplishments have come at a price? Here is a look at The Dallas Morning News’ coverage of allegations of billing fraud, lax resident supervision, preferential medical treatment and possible patient harm at the publicly funded institutions: